In the past, eating disorders such as anorexia and bulimia were seen to be exclusively Western concerns. However, cultural developments such as urbanization and westernization are linked to a rise in the numbers of those affected by these conditions in India. Since eating disorders are more difficult to overcome when patients are in the throes of the latter stages of the disease, a preventive approach is necessary, as is early diagnosis. Where medical examinations are undertaken in schools, medical professionals should pay attention to the early signs and symptoms of these diseases, and should consider practices such as weigh-ins, asking students to complete questionnaires on their eating habits, or providing both students and teachers with educational workshops in which the subjects of eating disorders and general nutrition, are addressed.
An important study on eating disorders in Bangalore:
A relatively recent study (2011) published in the International Journal of Eating Disorders set out to discover whether eating disorders were a significant clinical issue in urban India. Some 66 Psychiatrists practicing in Bangalore took part in the study. They reported that they had attended to a total of 74 patients with eating disorders in the previous year. Some 32 patients had anorexia nervosa, 12 bulimia nervosa and 30 eating disorders which were not otherwise specified. The authors of the study concluded that “two-thirds of psychiatrists reported seeing at least one case of eating disorders, indicating that eating disorders are not uncommon in urban India”. The issue remains as to how both public outreach programs and teachers at school can ensure children are keeping healthy, when signs and symptoms of these disorders may be difficult to detect. Since the causes of eating disorders are varied (they are generally attributable to a blend of biological, psychological and environmental factors), it is important that those who may be affected by this condition be referred to the appropriate specialist in the matter. Eating disorders can be extremely difficult to overcome and usually require help from a multi-dimensional team, which includes doctors, nutritionists and psychiatrists/ therapists specializing in cognitive behavioral therapy.
What can teaching staff and public outreach professionals do to help?
It is important that teachers and public outreach professionals be on the alert for eating disorders, since sufferers can be quite adept at hiding their condition. Anorexia can often be easier to detect, since extreme weight loss will usually be observable. Bulimia, on the other hand, in which patients binge eat then purge, can be impossible to detect through mere physical inspection, since those with those conditions can be within their normal weight range. Finally, it is important to note that new eating disorders have recently been identified – including Binge Eating Disorder (BED) – similar, to an extent, but not identical to bulimia. Those suffering from BED can have insatiable cravings at any hour of the day or night, leading to bingeing, followed by strong feelings of guilt or shame.
Common symptoms of eating disorders:
Some of the most common symptoms of anorexia include: extreme weight loss, excessive exercise or dieting, loss of the menstrual cycle, hair loss on the head and hair growth on the body owing to protein insufficiency, and having a distorted image of one’s body. Symptoms of bulimia include bingeing and purging, swollen salivary glands and broken blood vessels in the eyes from purging, and an abuse of diet pills and/or laxatives. BED, meanwhile, cannot be detected by a physical examination; rather, the presence of this disorder must be elicited from the person by asking them questions. It is important to find out if they binge, lie about the amount of food they eat and/or feel guilty after bingeing.
A matter of education
In addition to staff being on the lookout for warning signs, educational programs for children are of great importance. Children should be taught the value of sound nutrition and dissuaded from following strict diets, since they can trigger conditions like anorexia. Severe diets can make the brain extra susceptible to tryptophan, an amino acid contained in food which can provoke anxiety when consumed. Moreover, the body has a normal appetite-reward system, in which we are meant to feel satisfied and happy after a meal. Unrealistic expectations of one’s body image and severe dieting can alter the body’s normal reaction, making us feel guilty and ashamed after eating, a characteristic symptom of the onslaught of anorexia.
The importance of support
Often, spotting an eating disorder is dependent upon a student/ young person sharing their true feelings and habits with their teacher or a medical professional at a public outreach program. Those dealing with youth suffering from eating disorders need to possess a supportive, non-judgmental attitude, so students are more likely to open up about what they are going through. Once a student admits to having a disorder or to indulging in destructive habits, they should be referred to a professional or organization that can help them being the sometimes long and arduous road to recovery. When it comes to eating disorders, the best approach is to nip them in the bud, or to prevent them happening at all.